BILL ANALYSIS Ó
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2015 - 2016 Regular
Bill No: AB 2193 Hearing Date: June 27,
2016
-----------------------------------------------------------------
|Author: |Salas |
|----------+------------------------------------------------------|
|Version: |April 5, 2016 |
-----------------------------------------------------------------
----------------------------------------------------------------
|Urgency: |No |Fiscal: |Yes |
----------------------------------------------------------------
-----------------------------------------------------------------
|Consultant|Sarah Mason |
|: | |
-----------------------------------------------------------------
Subject: California Board of Podiatric Medicine: Physician
Assistant Board: extension
SUMMARY: Extends the operation of the Board of Podiatric Medicine
(BPM), the operation of the Physician Assistant Board (PAB), and
the PAB's authority to appoint an executive officer from January
1, 2017 to January 1, 2021.
Existing law:
1)Establishes the BPM within the jurisdiction of the Medical
Board of California (MBC) until January 1, 2017. Provides
that the repeal of the enacting statute renders the BPM
subject to review by the appropriate policy committees of the
Legislature. (Business and Professions Code (BPC) § 2460)
2)Establishes the PAB within the jurisdiction of the MBC until
January 1, 2017. Provides that the repeal of the enacting
statute renders the PAB subject to review by the appropriate
policy committees of the Legislature. (BPC § 3504)
3)Requires, until January 1, 2017, and except as provided in BPC
§§ 159.5 and 2020, the PAB to employ within the limits of the
Physician Assistant Fund all personnel necessary to carry out
the provisions of the Physician Assistant Practice Act,
including an executive officer who shall be exempt from civil
service. Requires the MBC and PAB to make all necessary
expenditures to carry out the provisions of the Physician
AB 2193 (Salas) Page 2
of ?
Assistant Practice Act from the Physician Assistant Fund.
(BPC § 3512)
This bill:
1)Extends the sunset dates for the BPM and the PAB until January
1, 2021.
2)Extends the PAB's authority to appoint an executive officer
until January 1, 2021.
FISCAL EFFECT: This bill is keyed "fiscal" by Legislative
Counsel. According to the Assembly Committee on Appropriations
analysis dated April 20, 2016, this bill will result in costs of
approximately $1.5 million per year for four additional calendar
years to continue the operation of the BPM and costs of
approximately $1.6 million per year for four additional calendar
years to continue the operation of the PAB.
COMMENTS:
1. Purpose. This bill is sponsored by the Author , and is one of
five "sunset bills" the Author is sponsoring this Session.
According to the Author, "because the boards are set to
sunset in 2017, the date needs to be extended to ensure the
continued regulation of the professions."
2. Oversight Hearings and Sunset Review of Licensing Boards and
Programs. Beginning in 2015, the Senate Business and
Professions Committee and the Assembly Business and
Professions Committee (Committees) conducted joint oversight
hearings to review 12 regulatory entities: Department of
Consumer Affairs (DCA), Acupuncture Board, Board of
Behavioral Sciences, California Massage Therapy Association,
Court Reporters Board, Board of Pharmacy, PAB, BPM, Bureau
for Private Postsecondary Education (BPPE), Board of
Psychology, Bureau of Real Estate, Bureau of Real Estate
AB 2193 (Salas) Page 3
of ?
Appraisers and Veterinary Medical Board.
The Committees conducted two hearings in March. This bill
and the accompanying sunset bills are intended to implement
legislative changes as recommended by staff of the Committees
and which are reflected in the Background Papers prepared by
Committee staff for each agency and program reviewed this
year.
3. Background on BPM. BPM is a licensing board under the DCA.
BPM licenses and regulates doctors of podiatric medicine
(DPMs). In the Medical Practice Act, a license to practice
podiatric medicine is called a "certificate," but it is
indistinguishable from other professional licenses. It is a
misdemeanor to practice podiatric medicine or use the title
DPM, podiatrist, or similar designation without a license.
The Practice Act defines "podiatric medicine" as all medical
treatment of the foot, ankle, and tendons that insert into
the foot, including diagnosis, surgery, and the nonsurgical
treatment of the muscles and tendons of the leg governing the
functions of the foot. Therefore, a DPM's scope of practice
is similar to that of a physician and surgeon who specializes
in the foot and ankle. However, unlike a physician and
surgeon, whose scope is only limited by the licensee's own
area of competence, a DPM's scope is limited by the license
to the foot and ankle. Historically, the BPM was a committee
within the Medical Board of California (MBC). Currently,
however, the BPM functions as an independent board, similar
to other licensing boards under the DCA. Still, the Practice
Act continues to describe the BPM as "within the jurisdiction
of" the MBC. As a result, the BPM makes recommendations for
DPM licensure to the MBC, while the MBC officially issues the
licenses, but defers completely to the judgment of BPM. The
BPM licenses approximately 2,000 DPMs. On average, it issues
106 licenses each year and renews on average 1,106 licenses
each year.
As a special fund agency, the BPM receives no general funds.
Instead, it relies on fees set by statute and collected from
licensing and renewal. The purpose of the BPM's licensing
program is to protect the public and consumers by ensuring
minimum competency in practitioners. Applicants for a DPM
license must graduate from a college of podiatric medicine
that has been approved by the BPM, pass Part I, II and III of
AB 2193 (Salas) Page 4
of ?
the national exam and successfully complete two years of
postgraduate training.
4. Review of the BPM - Issues Identified and Recommended
Changes. Committee staff identified 11 issues pertaining to
BBS and provided background information concerning each
issue. Recommendations were made by Committee staff
regarding the particular issue areas which needed to be
addressed. Only one of the identified issues for BPM
required a statutory change.
a) Issue : Continued Regulation of the Profession by BPM.
Background : The health, safety and welfare of consumers
are protected by the presence of a strong licensing and
regulatory board with oversight over DPMs. The BPM has
shown a commitment to its mission and a willingness to work
with the legislature to improve consumer protection.
Therefore, the BPM should be continued with a 4-year
extension of its sunset date so that the Legislature may
once again review whether the issues and recommendations in
this Background Paper have been addressed.
Recommendation and Proposed Statutory Change : The committee
recommends that DPMs continue to be regulated by the
current the BPM members in order to protect the interests
of the public and be reviewed again in four years.
This bill extends the operation of BPM for four years.
5. Background on PAB. PAB is also a licensing board under DCA.
PAB licenses and regulates physician assistants (PAs). PAs
provide health care services under the supervision of a
physician and surgeon. PA functions include performing
diagnostic, therapeutic, preventive, and health maintenance
services. Currently, the PAB has over 10,000 licensed PAs.
Historically, the PAB was a committee within the MBC,
however, the current PAB is an independent board with
regulatory authority to enforce the Physician Assistant
Practice Act. The PAB still utilizes many of the MBC's
services, including enforcement, information technology, and
fund management via a contract with MBC.
The PAB's mandates include:
AB 2193 (Salas) Page 5
of ?
Approval of the educational and training
requirements of PAs
Licensing of PAs.
Promoting the health and safety of California
health care consumers by enhancing the competence of
PAs.
Coordinating investigation and disciplinary
processes
Providing information and education regarding the
PAB or PA professionals to California consumers.
Managing a diversion/monitoring program for PAs
with alcohol/substance abuse problems.
1. Review of PAB - Issues Identified and Recommended Changes.
Committee staff identified 10 issues pertaining to PAB and
provided background information concerning each issue.
Recommendations were made by Committee staff regarding the
particular issue areas which needed to be addressed. Only
one of the identified issues for PAB required a statutory
change.
a) Issue : Continued Regulation of the Profession.
Background : The health, safety and welfare of consumers
are protected by the presence of a strong licensing and
regulatory board with oversight over PAs. The PAB has shown
a commitment to improve its overall efficiency and
effectiveness and has worked cooperatively with the
Legislature and the Committees to bring about necessary
changes. Therefore, the PAB should be continued with a
4-year extension of its sunset date so that the Legislature
may once again review whether the issues and
recommendations in this Background Paper have been
addressed.
Recommendation and Proposed Statutory Change : The licensing
and regulation of PAs should continue to be regulated by
the current members of the PAB in order to protect the
interests of the public and be reviewed once again in four
years.
This bill extends the operation of PAB and PAB's authority
to appoint an EO for four years.
AB 2193 (Salas) Page 6
of ?
2. Related Legislation This Year. SB 1039 (Hill), among other
changes to the operations and fee structure of a number of
boards under DCA, gives BPM their own chapter in the Business
and Professions Code and formally separates it from the
Medical Board, reflecting operational realities. ( Status:
The bill is currently pending in the Assembly Committee on
Business and Professions.)
SUPPORT AND OPPOSITION:
Support:
California Academy of Physician Assistants
Opposition:
None on file as of June 21, 2016.
-- END --